Encore! EP402: What Physicians Trying to Clinically Integrate Care in the Real World Need to Know, With Amy Scanlan, MD

In this encore episode, host Stacey Richter speaks with Dr. Amy Scanlan, Chief Medical Officer of the Clinically Integrated Network, a joint venture between Intermountain Health and UC Health in Colorado. They discuss the complexities of transitioning to value-based care, including the need for infrastructure, data, technology, and team collaboration. Dr. Scanlan emphasizes the importance of listening to practices, fostering medical culture change, and addressing the powerful influence of fee-for-service incentives. They also explore the necessity of strong interpersonal relationships and the critical role of leaders in facilitating effective care integration. Despite the challenges, Dr. Scanlan offers valuable advice for those embarking on the journey toward clinically integrated networks.

WHAT YOU'LL LEARN

✅ What it takes to transition to value-based care: infrastructure, data, technology, and team collaboration all have to move together

✅ Why "the hard part is the in-between spaces," and how Dr. Scanlan thinks about helping practices get from fee-for-service to integrated care

✅ Why team-based care done badly is "really just a series of handoffs" instead of true collaboration

✅ Why physicians need to be accountable for cost of care as well as outcomes, and how physician burnout paradoxically gives Dr. Scanlan hope

✅ Dr. Scanlan's practical advice for anyone trying to stand up a Clinically Integrated Network (CIN)

WHY THIS MATTERS

"Team-based care done badly is really just a series of handoffs." Dr. Scanlan's core argument is that clinical integration isn't primarily a technology problem — it's a culture and relationship problem. Infrastructure and data matter, but without genuine collaboration and shared accountability for cost and outcomes, integration stalls in what she calls "the in-between spaces."

MENTIONED IN THIS EPISODE

EP407 with Vivek Garg, MD, MBA: Apple Podcasts | Spotify | Other Apps

EP393 with David Muhlestein, PhD, JD: Apple Podcasts | Spotify | Other Apps

=== LINKS ===

🔗 Show Notes with all mentioned links: Episode Page

🔗 Healthcare Industry Acronyms and Terms

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00:00 Introduction

06:35 How is Dr. Scanlan thinking about the transformation process and the shift to value?

09:16 "It is really trying to think about, how do we help practices get there?"

11:48 "The hard part is the in-between spaces."

14:12 "Team-based care done badly is really just a series of handoffs."

15:52 "We have to get to that point where the culture of collaboration is more pervasive."

19:58 "How do we as healthcare providers step in and solve this problem?"

20:06 Why do providers have a responsibility to step in and try to fix the healthcare system?

20:22 Article (unpaywalled) by Eric Reinhart, MD, PhD.

21:51 Why do physicians need to be accountable for the cost of care as well as outcomes?

23:38 Why does physician burnout give Dr. Scanlan hope?

24:26 What is the solution to changing fee-for-service incentives?

25:43 What are some of the challenges facing changing incentives?

27:16 Why is data so important?

30:13 "It's important to understand that we are in the middle of this change."

31:18 Dr. Scanlan's advice for those trying to stand up a CIN.